This article is more than 5 years old. Information may no longer be current.

Institutional system changes may improve ankle fracture fixation outcomes

Add topic to email alerts

Receive an email when new articles are posted on

Please provide your email address to receive an email when new articles are posted on .

Subscribe

Added to email alerts

You've successfully added to your alerts. You will receive an email when new content is published.

Click Here to Manage Email Alerts

You've successfully added to your alerts. You will receive an email when new content is published.

Click Here to Manage Email Alerts

Back to Healio

We were unable to process your request. Please try again later. If you continue to have this issue please contact customerservice@slackinc.com.

Back to Healio

BOSTON — Institutional system changes for treatment of ankle fractures may reduce malreduction and complication rates, according to results presented at the American Orthopaedic Foot & Ankle Society Annual Meeting.

“Ankle fractures should not be treated as simple fractures and even less complex ones can be fixed poorly,” Andrew Molloy, FRCS(Tr&Orth), said in his presentation, which was an International Federation of Foot and Ankle Societies Award for Excellence finalist. “Education alone is ineffective in producing change as it emphasizes what has been done badly, not what one should do.”

Molloy and colleagues collected patient clinical data and scored image intensifier films based on the Pettrone criteria during three time points.

Among 94 patients who underwent ankle fracture fixation in 2009, Molloy noted a malreduction rate of 33% and a major complication rate of 8.5%.

According to Molloy, a period of re-education was implemented after these results that included presentations of departmental meetings and teaching of junior staff. He noted they reviewed 64 patients who underwent ankle fracture fixation from a 7-month period in 2014 and found a deterioration in outcomes.

“The malreduction was 43.8%. The major complication rate was 10.9%,” Molloy said.

Finally, he said multiple system changes were implemented throughout the department, including new treatment algorithms, dedicated foot and ankle trauma lists and clinics and next-day review of all intraoperative radiographs by independent attendings, among other changes. From January 2015 to September 2016, researchers collected prospective data on 205 patients who underwent ankle fracture fixation.

“The results of the system changes are hugely significant,” Molloy said. “It went down to a malreduction rate of 2.4% and a complication rate of 1%.” – by Casey Tingle

Reference:

Molloy A, et al. Fixation of ankle fractures: Experiences in improving quality. Presented at: American Orthopaedic Foot & Ankle Society Annual Meeting; July 11-14, 2018; Boston.

Disclosure: Molloy reports he is a paid presenter or speaker for OrthoSolutions and Stryker, and is a paid consultant for Stryker.